[Service Records found showing evidence of service connected injury 8 years after VA Claim decided not service connected]

While working on a currently claim I have spend a lot of time going through records and such. Oddly the VA sent my therapist a disk with a shit ton of my personal medical records from the time I signed up in 2004 to the time I exited in 2011. He didn't know why they sent him these and he gave them to me rather than throw it away.

It took me a long time to go through all of them seeing if there was anything in there for my current claim. Some of these records I have requested without ever receiving. So this was an awesome surprise! Anyway, I found records showing my Left Hand Injury was indeed military related. The one doctors report showed the injury and described how it happened. I claimed this injury and in 2012 they put it in my claim as no rating at all and "Not Service Connected". I couldn't obtain any evidence on this at the time and it became my word against theirs. BUT NOW I HAVE THE EVIDENCE! 

So my question is (as I don't want to make a mistake filing) How do I go about having this changed 8 years later? If I submit this evidence now will it mess up my current claim that is in the review process and should be done very soon? Could it help my current claim? Sometimes I get arthritic pain or my hand will just be swollen but it isn't daily. So I would assume automatically I would get a 0% for it being service connected with just  new submitted old military record proof? Or will they send me in for an eval? Thanks!

[Old closed claim injuries added to current claim and I didn't add them. Also what does appeal substitution review mean on claim status?]

20 hours ago, GeekySquid said:

In general it looks like the VA rate builder triggered and they want to bump you to 100% under TDIU, which is good for you based on your description.

The VA pay rate table shows  this

70% - 100% Without Children

Dependent Status	70%	80%	90%	100%
Veteran Alone	$1,403.71	$1,631.69	$1,833.62	$3,057.13
Veteran with Spouse Only	$1,522.71	$1,767.69	$1,986.62	$3,227.58
Veteran with Spouse and One Parent	$1,617.71	$1,876.69	$2,109.62	$3,364.37
Veteran with Spouse and Two Parents	$1,712.71	$1,985.69	$2,232.62	$3,501.16
Veteran with One Parent	$1,498.71	$1,740.69	$1,956.62	$3,193.92
Veteran with Two Parents	$1,593.71	$1,849.69	$2,079.62	$3,330.71
Additional for A/A spouse (see footnote b)	$109.00	$125.00	$141.00	$156.32

80 to 90 is a couple hundred a month, 80 to100 (even tdiu) is about 1400 a month for a single vet.

you can see it here

https://www.benefits.va.gov/COMPENSATION/resources_comp01.asp

 

AS for that Appeal Substitution Review language it looks like they are trying to help you get to 100 Schedular instead of TDIU. VA has to maximize your award and Schedular, if possible, is better than TDIU as TDIU has limitations on future income just like SSDI does and requires annual verification and reporting from you. With Schedular those things are eliminated.

Others may have a different reading on that language.

 

this language is common in files

Exam Request - Request for Clarification No longer needed

VES notification to you is lagging behind the VA decision process.

It all looks favorable to you. Hopefully you will update us so we can congratulate you!

Thanks for the info and input Squid! Yes this "File: ClaimDecisionRequest.pdf
Type: Appeal Substitution Review" didn't show up on my claim until the instant I hit the "Claim Decision Request" button after all evidence had been submitted. So maybe that is just standard on what comes up when that button is pushed?

 

I also had evidence of a letter from Unemployment denying me all unemployment benefits (this just floors me) and their reasoning was "me, my last job, or someone else told them my illness was preventing me from looking for a job or becoming employed" Go figure....so I sent that in with my TDIU form they asked me to fill out.

 

Yes they also retropaid me for the extra $200month for the increase of 50-70% which brought me to 90% overall. So that is positive. So far the process has moved pretty quickly. I have been impressed with it this go around. Is there different benefits of 100% and 100%TDIU for my family? I have a wife and two children. I will keep you updated on my end! THANK YOU!

[Old closed claim injuries added to current claim and I didn't add them. Also what does appeal substitution review mean on claim status?]

So we are curious...

Have been at 80% since 2011 but things have progressed with mental status and being able to keep a job and function like normal. I decided to apply for an increase in PTSD on Jan. 9, 2019. I had a very weird C&P exam where it lasted literally 20min  and nothing was really asked much about anything. My previous exam for this was very traumatizing and it disrupted my life for weeks after. Every trigger they could hit, they did. This time was very different. I was very thrown off by it as I was so worked up thinking about the last one I didn't sleep for 2 weeks prior to this one. This time the doctor said "I will suggest you are put in for an increase, God Bless you, and thank you for your service". Less than a month later they moved my PTSD from 50% TO 70% which brought me to 90%. I saw this in my bank account before I saw it in Ebenefits and way before I got the notice in the mail. When the notice came in the mail it said "at 90% pending return of TDIU form". The VA then sent me a form for TDIU. I have never heard of them actually sending/requesting to fill out this form, have you? I figured maybe they wouldn't send it if they didn't plan on considering it? So I filled it out and sent it back in.

At about the same time i submitted the TDIU papers I saw on my claim that 5 of my old physical injuries that were previously rated were added to my claim (both knees, both legs, and back) and in parenthesis after the description it said "(INCREASE)". I didn't add these to this claim, they were previously rated and closed claims. What does this mean? Has anyone had this happen before? A week or so later they also sent a request to disclose medical records from outside providers. In the same letter it said they will wait 30 days to process my claim unless I am done submitting evidence. If I was done submitting please check box (or do it online) that you are ready for a claim decision and that I have submitted all evidence I have.

Because they added the extra things on my claim, and my physical pain has been increasing as I have gotten older, I went ahead and sent in records from my physical therapist and such that were all done outside the VA since 2011. Because I had nothing left to send in, I then clicked on the button "decide my claim, I have no additional evidence to submit" and after that, this is what showed up in my claim status "File: ClaimDecisionRequest.pdf Type: Appeal Substitution Review". What does Appeal Substitution Review mean? It seems kind of confusing. I don't want to assume anything!

I also just got an email that 2 days ago from VES where I got my C&P notifying me that the VA claims requested clairification from my medical records from them. Looking at my claim it shows "Exam Request - Request for Clarification No longer needed"  I've also never had this happen. Maybe this is all positive things?

It is all really odd to me, as all my other experiences in the past years have not been like this. In the past it was a horrible process to deal with and very long and drawn out. It currently seems to  be moving very fast this time around, which is a load off. I am hoping its all positive as I am currently not doing well and not able to work. It would be helpful to get my 100% to help support my family right now. I have been out of work since February. Just curious what your thoughts are on this and if anyone has had anything similar happen as described above?

There is nothing left to do but wait. Thanks in advance, I appreciate the input!